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The sinonasal anatomy in growing children undergoes change in size along with progressive pneumatization, this is of particular significance in endoscopic endonasal surgery. We aim to measure and quantify the sinonasal dimensions in the Indian paediatric population, which are relevant to skull base surgeons.This is a retrospective radio anatomical study of sinonasal measurements and volumetric analysis of the sphenoid sinus performed on archived CT images of children less than 18 years of age.CT scan images of 110 patients (male, 68; female, 42) were included for the study. The number of patients in each age groups was as follows [0-6 years, 17; 7-9 years, 20; 10-12 years, 27; 13-15 years, 29; 16-18 years, 17]. The distance from the nares to the sphenoid and from the sphenoid to the sella was significantly greater in children of 13-15 years (69.4 ± 5.2 mm) as compared to children less than six years (62.6 ± 6.7 mm) (P0.003). The volume of the sphenoid in children between 0 and 6 years was 4641.4 ± 1924.7 mmThe sinonasal anatomy shows progressive development between the age of 6 to 15 years after which it plateaus. The pneumatization in young children may be incomplete, which necessitates drilling in the sphenoid sinus. The intercarotid distance was not seen to be a hindrance for endoscopic endonasal surgery. None of the measurements of the skull-base, made in this study appear to restrict endoscopic endonasal surgery in children. However, a meticulous preoperative assessment of the CT scan may be needed for optimal surgical outcome.

AIM To study the clinical profile, imaging features, intra-operative findings, post-operative outcome at discharge and at 6 months in patients with internal carotid artery (ICA) bifurcation aneurysm. MATERIAL AND METHODS Present study is a retrospective analysis of data of patients who underwent surgery for ICA bifurcation aneurysm between the period of 1st January 2011 to 31st December 2015 at our institute. Demographic variable, clinical grade, radiological finding was assessed. Outcome was measured using modified Rankin score (mRs) at discharge and at 6 months follow up. All ICA bifurcation aneurysms were clipped using a standard pterional craniotomy. RESULTS A total of 28 patients were included in the study out of which 4 had bilateral ICA bifurcation aneurysms. Mean age was 44.15 (age range 14-65) years, with 43.75% of patient were < 40yrs. Multiple aneurysms were seen in 11 (39.28%) patients, with superior projection being the most common in 53.12%. Vasospasm was seen in 12 (42.85%) with 4 patients undergoing chemical angioplasty. At discharge good outcome (mRs < 3) was seen in 4/5 (80%) patients in the un-bled category, whereas 18/23 (78.2%) in bled category. At 6 months follow up, mRs < 3 was seen 4 (100%) patients in unbled category, and 84.21% (16 of 19) patients in bled group. CONCLUSION The findings of the present study have shown an increased incidence of bilaterality and multiplicity for ICA bifurcation aneurysms. The direction of the dome of aneurysm and temporary clipping do not affect the treatment outcomes. These aneurysms have excellent outcomes following surgery.

Background: The aim was to study effectiveness of TLIF procedure by assessing clinical and radiological spinal sagittal parameters pre and postoperatively.Methods: 8 patients who underwent TLIF procedure after diagnosis of spondylolisthesis studied prospectively. After recording general information, symptomatology, functional parameters were evaluated using visual analogue scale (VAS), Oswestry disability index (ODI), short form 12 (SF 12) and radiological sagittal balance parameters were assessed by calculating sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), preoperatively and postoperatively during follow up at 1 and 3 months.Results: We operated 4 (50%) patients at L4-L5 level of degenerative spondylolisthesis, 1 (12.5%) patient of degenerative spondylolisthesis at L5-S1 level and 3 (12.5%) patients of isthmic spondylolisthesis at L5-S1 level. All patients were grade 1 spondylolisthesis according Meyerding classification. After surgery all sagittal spinal balance parameters were not found to be statistically changed from the baseline, although there was minimum improvement. Regarding the clinical outcome measures, both VAS (